Skin graft pressure pad

Abstract

Apparatus and method for applying more uniform pressure to an area of skin that is undergoing a skin graft. Pressure pad comprises a soft, pliable, transparent plastic envelope fillable with a viscous, transparent liquid to provide even distribution of pressure while permitting visual inspection of, and transmission of radiation to bathe the skin graft area, without removal of the pressure pad. Pad is removably securable to the area adjacent the graft by a variety of securing means. In one embodiment the graft area contact surface of the pad is specially adapted to permit air to contact the graft tissue. Pad is sterilizable, and the envelope is of a nature that drying tissue and serous fluid will not adhere to it. Pad preferably has a port permitting precise control of the amount of liquid fill (preferably silicone) in the bag, introduced or withdrawn by means of a syringe. In turn, this permits precise control of the pressure applied to the graft tissue. Pad structure is adapted to be highly conformable to irregular surface contours insuring full contact and uniform hydrostatic pressure on graft tissue.

I claim: 
     
       1. A skin graft pressure pad comprising in operative combination: (a) means defining an enclosure for a liquid mass comprising a soft, easily deformable, transparent plastic bag and having a property of low adherence to tissue or serous fluids on at least one skin graft contact surface thereof;   (b) said enclosure means being pliable, freely conformable to variations in surface contour, and non-freestanding;   (c) at least one substantially transparent liquid disposed in said enclosure in an amount to at least partially fill said enclosure to permit said free surface conformability;   (d) the volume of said enclosure and amount of said liquid being selectable to provide mass sufficient to enhance growth-promoting contact between grafted tissue and underlying tissue without substantial tissue necrosis;   (e) means for removably securing said enclosure containing said liquid in contact with said graft tissue; and   (f) said securing means being adapted to retain said pad in a predetermined position in direct continuous contact with said graft tissue to permit said liquid to transmit substantially uniform, growth-promoting pressure to said graft tissue without inducing substantial tissue necrosis.   
     
     
       2. A pressure pad as in claim 1 wherein said securing means comprises a plurality of flexible members disposed to permit visual observation of at least a portion of said graft tissue through said enclosure and said liquid. 
     
     
       3. Pressure pad as in claim 2 wherein said flexible members comprise a mesh. 
     
     
       4. A pressure pad as in claim 2 wherein said flexible members comprise filamentous tie-downs adapted to be secured to sutures. 
     
     
       5. Pressure pad as in claim 2 wherein said flexible members comprise flexible strips. 
     
     
       6. Pressure pad as in claim 1 which includes a web extending from the margin of said pad along at least a portion of the periphery of said pad. 
     
     
       7. Pressure pad as in claim 1 which includes at least one port for introduction or withdrawal of said liquid thereby permitting control of the mass of said pad. 
     
     
       8. Pressure pad as in claim 1 wherein the surface of said enclosure placed adjacent said graft is adapted to provide passages for fluid. 
     
     
       9. Pressure pad as in claim 1 wherein said liquid is selected from a silicone fluid, water, and water having a gelling agent therein, the viscosity of said liquid ranging from about 1 to 12,000 centistokes. 
     
     
       10. Pressure pad as in claim 9 wherein said liquid has a viscosity in the range of from about 100 to 10,000 centistokes. 
     
     
       11. Pressure pad as in claim 10 wherein said liquid is a dimethyl polysiloxane silicone fluid. 
     
     
       12. Method of applying uniform pressure to a skin graft comprising the steps of: (a) selecting a partially full, liquid-containing pressure pad having a graft-tissue-facing surface larger than the area of said graft, said pressure pad comprising a soft, easily deformable, non-freestanding transparent plastic bag, and having a property of low adherence to tissue and serous fluids on at least one skin graft contact surface thereof;   (b) applying said pressure pad in free surface conformability to said area;   (c) maintaining said pad in direct continuous contact with said graft tissue with removable securing means; and   (d) maintaining the pressure pad of said pad on said graft area by adjusting the tightness of said securing means relative to the amount of said liquid in said pad;   thereby transmitting uniform pressure sufficient to promote contact between said graft tissue and underlying base tissue without substantial necrosis of said tissues.   
     
     
       13. Method as in claim 12 wherein said step of maintaining the pressure of said pad includes controlling the volume of liquid in said pad after said pad is secured in place, said controlling is selected from introducing and withdrawing liquid from said pad by a syringe means. 
     
     
       14. Method as in claim 12 which includes the step of inspecting the progress of the taking of said graft by viewing the graft tissue through said pad. 
     
     
       15. Method as in claim 12 which includes the step of irrigating said graft tissue with a fluid introduced in spaces provided between said pad and an upper surface of said graft tissue. 
     
     
       16. Method as in claim 12 wherein said step of maintaining said pad in place includes providing sutures in skin tissue to which said pad is secured. 
     
     
       17. Method as in claim 12 wherein said step of maintaining the pressure of said pad includes selecting the fluid in said pad to permit said pad to freely conform to irregularities of contour in said skin surface. 
     
     
       18. Method as in claim 17 wherein said step of fluid selection includes controlling the viscosity of said fluid in the range of from 1-12,000 centistokes. 
     
     
       19. Method as in claim 18 wherein said viscosity is controlled in the range of from 100 to 10,000 centistokes.